Unique procedure helps couple in their 90s enjoy life again

Thanks to TAVR, the couple, both in their 90s, are back at home feeling energetic and happy. Joining them are (top left) Dr. Jacob Scheinerman, vice chair of cardiothoracic surgery at LIJ and (top R) Dr. Barry Kaplan, vice chair, cardiology, LIJ.

Marie and Joseph Nigro of New Hyde Park believe in sharing everything.

They eat the same foods, enjoy the same type of music and, after 66 years of marriage, discovered they were both suffering from aortic stenosis.

“It got so bad that my husband couldn’t even tie his shoes,” said the 90-year-old Ms. Nigro at a recent LIJ Medical Center news conference she attended with her spouse and children. The Nigros were joined by their doctors, Jacob Scheinerman, MD, and Barry Kaplan, MD.

Aortic stenosis is so debilitating that it often affects such day-to-day activities as walking short distances or climbing stairs. Generally affecting people older than 70, the disorder occurs when the aortic valve doesn’t open and close properly, usually due to a calcium buildup. The calcium blockage restricts blood flow from the heart to the rest of the body, thereby increasing pressure within the heart, compounding the risk of heart failure. Symptoms include extreme fatigue, chest pain or pressure, shortness of breath and fainting. All of these symptoms were becoming very familiar to the Nigros.

THE UNIMAGINABLE BECOMES REAL

Dr. Scheinerman, vice chair of cardiovascular and thoracic surgery at LIJ, treated both Mr. and Ms. Nigro with transcatheter aortic valve replacement (TAVR). During the procedure, doctors use a catheter to guide a replacement heart valve through the bloodstream, starting at the femoral artery in the thigh. The cardiac team uses transesophageal echo and fluoroscope imaging for precise placement. Inside the heart, the replacement heart valve is expanded to about the diameter of a quarter, pushing away the calcium to enlarge the opening. The surgeon then anchors it inside the aorta and blood flow is restored.

“Ten or even five years ago, this procedure would have seemed unimaginable,” said Dr. Scheinerman. “To be able to offer this to our patients who are unable to withstand a traditional heart surgery — to see patients like the Nigros undergo an hour-long procedure and then return home in less than a week — it’s still amazing to me. This is why we become surgeons.”

Mr. Nigro’s procedure, which lasted an hour and 20 minutes, took place in early June. A week later, the 92-year-old went home. He reported that when the procedure was finished, he “didn’t even know it had started yet. I felt absolutely nothing.”

After witnessing her husband’s improvement and realizing that she, too, was at risk, Ms. Nigro, 90, underwent the same procedure in mid-summer, then returned home four days later. She said that she has lots more energy and is very happy that she and her husband had the TAVR procedure because “we don’t feel old anymore.”

The Nigros helped LIJ achieve a milestone, surpassing 100 TAVR procedures performed by the hospital’s cardiologists and cardiothoracic surgeons since the technology debuted at LIJ in January 2012. In addition to the procedures performed at LIJ, North Shore University Hospital has implanted more than 40 TAVRs.

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